Nokea
for a child with meningitis, to monitor him for hydrocephalus you should
- A. measure head circumference.
- B. monitor convulsions.
- C. assess pupil size.
- D. watch for vomiting.
Correct Answer: A
Rationale: Monitoring head circumference is essential in children with meningitis to assess for possible development of hydrocephalus. Hydrocephalus is a potentially serious complication that can occur following meningitis. An increase in head circumference can indicate the accumulation of cerebrospinal fluid in the brain due to hydrocephalus. Regularly measuring the head circumference allows healthcare providers to detect any early signs of hydrocephalus and take appropriate actions such as further imaging or intervention. Monitoring for convulsions, assessing pupil size, and watching for vomiting are important aspects of care for a child with meningitis but are not specific to monitoring for hydrocephalus.
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Inhalation of carbogen for short period is recommended:
- A. To stimulate respiration
- B. To dilate blood vessels
- C. To dislodge the blood clot
- D. All of the above
Correct Answer: D
Rationale: Inhalation of carbogen, which is a mixture of carbon dioxide and oxygen, for a short period can have several beneficial effects.
The nurse is teaching the parent of a child newly diagnosed with JRA. The nurse would evaluate the teaching as successful when the parent is able to say that the disorder is caused by:
- A. The breakdown of osteoclasts in the joint space causing bone loss.
- B. The loss of cartilage in the joints.
- C. The buildup of calcium crystals in joint spaces.
- D. The immune-stimulated inflammatory response in the joint.
Correct Answer: D
Rationale: The correct answer is D. Juvenile rheumatoid arthritis (JRA) is caused by the immune-stimulated inflammatory response in the joints. In JRA, the body's immune system attacks its own healthy joint tissues, leading to inflammation, pain, and damage to the joints. This chronic inflammation can cause joint stiffness, swelling, and in severe cases, joint deformities. It is not caused by the breakdown of osteoclasts in the joint space (A), the loss of cartilage in the joints (B), or the buildup of calcium crystals in joint spaces (C).
Which are clinical manifestations of the postterm newborn? (Select all that apply.)
- A. Excessive lanugo
- B. Increased subcutaneous fat
- C. Absence of scalp hair
- D. Parchment-like skin
Correct Answer: D
Rationale: Postterm newborns are infants born after 42 weeks of gestation. Some common clinical manifestations of postterm newborns include parchment-like, wrinkled skin due to prolonged exposure to amniotic fluid, and long fingernails as a result of intrauterine growth beyond the expected term. Excessive lanugo and absence of scalp hair are not typically seen in postterm newborns. Increased subcutaneous fat may be more common in infants born at term or post-term, but it is not a specific clinical manifestation of postterm newborns. Minimal vernix caseosa is also usually present in postterm newborns.
A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, especially on awakening. These manifestations suggest:
- A. viral conjunctivitis.
- B. allergic conjunctivitis.
- C. bacterial conjunctivitis.
- D. conjunctivitis caused by foreign body.
Correct Answer: C
Rationale: The symptoms described by the parent, which include inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, are indicative of bacterial conjunctivitis. Bacterial conjunctivitis is typically associated with these symptoms, along with redness, irritation, and a sensation of a foreign body in the eye. It is common for bacterial conjunctivitis symptoms to be most pronounced upon awakening due to the accumulation of discharge overnight. Treatment for bacterial conjunctivitis often involves antibiotic eye drops.
Why does the nurse instruct the client to avoid Valsalva maneuvers?
- A. Clients BP will decrease momentarily
- B. Client may lose consciousness
- C. Client may suffer from a myocardial
- D. Clients BP will increase momentarily infarction
Correct Answer: C
Rationale: The nurse instructs the client to avoid Valsalva maneuvers because the client may suffer from a myocardial infarction. The Valsalva maneuver involves forcefully trying to exhale against a closed airway, which can increase intra-thoracic pressure and subsequently increase blood pressure. This can lead to an increased workload on the heart, potentially causing myocardial ischemia or infarction in individuals with underlying heart conditions. Therefore, it is important to avoid Valsalva maneuvers, especially in clients at risk for cardiovascular issues.